Laryngeal Cancer

Treatment for cancer of the larynx, or voice box, can change the way your voice sounds. Speech-language pathologists, or SLPs, can help.

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About Laryngeal Cancer

Your vocal folds are inside your larynx (pronounced LAR-inx), or voice box. When you talk, air moves from your lungs through the vocal folds to your mouth. The vocal folds vibrate to produce sound. Cancer can form on your vocal folds or other parts of your larynx.

Signs of Laryngeal Cancer

Some signs of laryngeal cancer may be

  • hoarseness or voice changes,
  • problems swallowing,
  • feeling like you have a lump in your throat or neck,
  • a bad cough or chest infection,
  • sore throat or cough that won’t go away,
  • shortness of breath,
  • unexplained weight loss,
  • ear pain that lasts for a long time.

Causes of Laryngeal Cancer

Risks of laryngeal cancer include

  • smoking or using chewing tobacco;
  • drinking alcohol a lot;
  • poor diet;
  • acid reflux (GERD);
  • a weakened immune system;
  • exposure to human papillomavirus (HPV); and
  • exposure to chemicals and other toxins, such as paint fumes or soot.

Testing for Laryngeal Cancer

You should see your doctor if you have any of the problems listed above. Your doctor can feel your throat for lumps and look down your throat to see your larynx.

The doctor may send you for scans and take a sample of the tissue in your larynx, called a biopsy. Your doctor tests the tissue to see if it is cancerous.

Treatments for Laryngeal Cancer

The treatment you get depends on the type of cancer you have, where it is located, and how much it has spread. You may need surgery, radiation, chemotherapy, targeted drug therapy, and/or immunotherapy.

Radiation and chemotherapy can cause changes such as a hoarse voice, sore throat, dry mouth, mouth sores, and problems breathing. You may also have some trouble swallowing. Some of these side effects go away after treatment is over.

Doctors use different types of surgeries to treat laryngeal cancer. Not all of them involve removing your larynx. Surgery to remove all of your larynx is called a laryngectomy. During laryngectomy, the surgeon will make a hole in your neck, called a stoma. You will breathe through this hole and need to learn new ways to communicate after surgery.

Speech and Swallowing Treatment

Speech-language pathologists, or SLPs, play an important role before, during, and after your cancer treatment to help with any speech or swallowing problems that you may have. You and your SLP might work with your doctor to discuss different ways to make your voice stronger. For further information about swallowing treatment, please see ASHA’s page on swallowing problems from head and neck cancer treatment.

Communication After Laryngectomy

The SLP will talk to you about your larynx and how surgery will change it. You will learn more about what will happen after surgery and what communication options you have. You and your family can discuss your options and treatment plan with the SLP.

Right after surgery, you will not be able to talk. The SLP can give you paper and a pen, a dry-erase board, or a picture board to help you tell others what you need. In addition, you can use technology such as phones or tablets to type messages or to generate electronic speech. As you heal, the SLP will work with you to find a new way to produce voice. There are three main options:

Artificial Larynx/Electrolarynx

You can use an electronic device that vibrates when turned on. You put the device against your neck or put a small tube in your mouth. Many people use this type of device first and may need to practice with an SLP in order to speak clearly.

Esophageal Speech

With this type of speech, you make sounds by taking air in your mouth, trapping it in your esophagus (the tube that goes from your throat to your stomach), and then pushing it back up through your throat and mouth to form words. It is like what happens when you burp. As the air goes out of your mouth, it makes the upper parts of your esophagus vibrate. Not everyone can learn this type of speech; it depends on the type of surgery or other cancer treatment that they had. It requires a lot of practice.

Tracheoesophageal Puncture

The tracheoesophageal puncture is a procedure that can be done either during the main cancer surgery or later. The surgeon makes a hole between your airway and your esophagus. A small one-way speaking valve goes into this hole. You breathe air in through the hole in your neck (stoma). You may use a “hands-free device,” or you may cover the hole up with a finger when you want to talk. When creating your voice, air from your lungs goes through the valve into the esophagus. The esophagus vibrates, and you use that to make sounds through your mouth. Your SLP will fit the valve, called a prosthesis, and will show you how to use and care for it.

To find a speech-language pathologist near you, visit ProFind.

Other Resources

This list does not include every website on this topic. ASHA does not endorse the information on these sites.

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